Caba Porras I, Cabello Muriel A, Oya Alvarez de Morales B, Marín Pozo J F, García Aranda J, Llácer Pérez C
Complejo Hospitalario de Jaén, Jaén, Spain.
Nutr Hosp. 2010 May-Jun;25(3):449-55.
Nowadays, there is a stronger consensus on the proceedings of nutritional support with parenteral nutrition (PN) in paediatrics, the prescription standards, its formulation, elaboration, and nutritional requirements in order to improve the process quality and the patient's safety. The use of standardized PN solutions in children is rare due to the difficulty to adapt them to every pathophysiologic condition. In order to do so, in 2006 we designed and validated a big range of standard solutions for children weighing more than 10 kg or being older than 1 year.
To assess the use of standard PN solutions and their suitability in children from January of 2006 until June of 2008: the frequency of prescription of standard solutions by age, weight, and indication, as well as their modifications. We compared the nutrients given by individualized PN solutions versus the recommendations of the Reference Guidelines and standardised PN.
47 children with a mean weight of 26.6 kg (9-50) and mean age 6.8 years (1-14) received 539 units of PN. Standardized PN (437) were used in 83% of the patients. Their total energy requirements were reached within 1-3 days by using one to three types of formulas. Only 4% (22) of them were modified, with easily feasible changes: volume increase (16), glucose lowering (3), and potassium increase (3). The analysis of the individualized PN in 8 children shows the same trend, with a caloric intake lower than 33% of the recommended one.
Standardized PN meet the nutritional requirements in most of the patients according to their morbid condition, highlighting their adaptability and versatility. Their use has eased the prescription-validation-preparation circuit and has improved the efficiency of the process.
如今,对于儿科肠外营养(PN)支持的流程、处方标准、配方、配制及营养需求,人们已达成更强的共识,以提高流程质量和患者安全性。由于难以使标准化PN溶液适应每种病理生理状况,儿童中使用标准化PN溶液的情况很少见。为了做到这一点,我们在2006年设计并验证了一系列适用于体重超过10公斤或年龄超过1岁儿童的标准溶液。
评估2006年1月至2008年6月期间标准化PN溶液在儿童中的使用情况及其适用性:按年龄、体重和适应证划分的标准溶液处方频率,以及其调整情况。我们将个体化PN溶液提供的营养素与参考指南和标准化PN的建议进行了比较。
47名平均体重26.6公斤(9 - 50公斤)、平均年龄6.8岁(1 - 14岁)的儿童接受了539单位的PN。83%的患者使用了标准化PN(437例)。通过使用一至三种配方,在1 - 3天内达到了他们的总能量需求。其中只有4%(22例)进行了调整,且调整很容易实现:增加体积(16例)、降低葡萄糖(3例)和增加钾(3例)。对8名儿童个体化PN的分析显示出相同趋势,热量摄入低于推荐量的33%。
标准化PN根据大多数患者的病情满足营养需求,突出了其适应性和通用性。其使用简化了处方 - 验证 - 配制流程,提高了流程效率。